Impact of Age and Diastolic Function on Novel, 4D flow CMR Biomarkers of Left Ventricular Blood Flow Kinetic Energy

Abstract

Two-dimensional (2D) methods of assessing mitral infow velocities are pre-load dependent, limiting their reliability for evaluating diastolic function. Left ventricular (LV) blood fow kinetic energy (KE) derived from four-dimensional fow cardiovascular magnetic resonance imaging (4D fow CMR) may ofer improvements. It remains unclear whether 4D LV blood fow KE parameters are associated with physiological factors, such as age when compared to 2D mitral infow velocities. Fifty-three healthy volunteers underwent standard CMR, plus 4D fow acquisition. LV blood fow KE parameters demonstrated good reproducibility with mean coefcient of variation of 6±2% and an accuracy of 99% with a precision of 97%. The LV blood fow KEiEDV E/A ratio demonstrated good association to the 2D mitral infow E/A ratio (r=0.77, P<0.01), with both decreasing progressively with advancing age (P<0.01). Furthermore, peak E-wave KEiEDV and A-wave KEiEDV displayed a stronger association to age than the corresponding 2D metrics, peak E-wave and A-wave velocity (r=−0.51 vs −0.17 and r=0.65 vs 0.46). Peak E-wave KEiEDV decreases whilst peak A-wave KEiEDV increases with advancing age. This study presents values for various LV blood fow KE parameters in health, as well as demonstrating that they show stronger and independent correlations to age than standard diastolic metrics.

Metadata

Authors/Creators:

Crandon, S.
Westenberg, J.J.M.
Swoboda, P.P.
Fent, G.J.
Foley, J.R.J.
Chew, P.G.
Brown, L.A.E.
Saunderson, C.
Al-Mohammad, A.
Greenwood, J.P.
van der Geest, R.J.
Dall'Armellina, E.
Plein, S.
Garg, P. https://orcid.org/0000-0002-5483-169X

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